DONATO R RICCI (NPI# 1417957432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417957432 |
| Entity Type | Individual |
| Full Name | DONATO R RICCI |
| Credential | MD |
| Practice Address |
3635 S Clyde Morris Blvd Suite 100 Port Orange FL 32129-2300 |
| Mailing Address |
4800 Belfort Road Jacksonville FL 32256 |
| Practice Telephone | 3867881242 |
| Practice Fax Number | 3867568802 |
| Mailing Telephone | 9043983262 |
| Mailing Fax Number | 9042654807 |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2011-05-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
ME 53429 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 270351300 | 05 |
| Street Address |
3635 S CLYDE MORRIS BLVD SUITE 100 |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033116975 | Gregory J. Stella | Internal Medicine | 3635 S Clyde Morris Blvd, Ste 100, Port Orange, FL 32129-2300 | 2005-07-07 |
| 1043690902 | C B Williamson | Orthopaedic Surgery | 3635 S Clyde Morris Blvd, Ste 600, Port Orange, FL 32129-2300 | 2015-06-05 |
| 1487050365 | Michel C. Samson, M.d., F.a.c.s., Pllc | Plastic Surgery | 3635 S Clyde Morris Blvd, Suite 400, Port Orange, FL 32129-2300 | 2014-11-05 |
| 1043654270 | Amsurg Port Orange Anesthesia, LLC | Anesthesiology | 3635 S Clyde Morris Blvd, Suite 500, Port Orange, FL 32129-2300 | 2013-04-18 |
| 1871849133 | Dorothy Whatley Porter | Physician Assistant | 3635 S Clyde Morris Blvd, Suite 100, Port Orange, FL 32129-2300 | 2012-07-24 |
| 1578836003 | C. Lawrence Slade, M.d., F.a.c.s., LLC | Specialist | 3635 S Clyde Morris Blvd, Suite 400, Port Orange, FL 32129-2300 | 2012-02-14 |
| 1841596327 | Srikanth Eathiraju | Orthopaedic Surgery | 3635 S Clyde Morris Blvd, Suite 900, Port Orange, FL 32129-2300 | 2011-02-01 |
| 1043520554 | C Lawrence Slade Md Facs LLC | Plastic Surgery | 3635 S Clyde Morris Blvd, Suite 400, Port Orange, FL 32129-2300 | 2010-10-18 |
| 1265693568 | Sarah E Henry | Orthopaedic Surgery | 3635 S Clyde Morris Blvd, Suite 900, Port Orange, FL 32129-2300 | 2008-06-19 |
| 1356519417 | Joanna Elizabeth Stoverink | Physician Assistant | 3635 S Clyde Morris Blvd, Ste 100, Port Orange, FL 32129-2300 | 2008-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003150715 | Vrushak Deshpande | Internal Medicine | 3635 Clyde Morris Blvd Ste 100, Port Orange, FL 32129-2349 | 2012-11-19 |
| 1487684171 | Hassan Zulfiqar | Internal Medicine | 1690 Dunlawton Ave, Suite # 210, Port Orange, FL 32127-8980 | 2006-07-05 |
| 1699775619 | Louis Michael Agnone | Internal Medicine | 3635 S. Clyde Morris Blvd, Ste 100, Port Orange, FL 32129 | 2005-08-01 |
| 1033116975 | Gregory J. Stella | Internal Medicine | 3635 S Clyde Morris Blvd, Ste 100, Port Orange, FL 32129-2300 | 2005-07-07 |
| 1093283905 | Ousama Alkhatib | Internal Medicine | 1690 Dunlawton Ave Ste 210, Port Orange, FL 32127-8980 | 2018-11-08 |
| 1427498724 | Town Center Medical Services, LLC | Internal Medicine | 1690 Dunlawton Ave Ste 120, Port Orange, FL 32127-8980 | 2013-07-01 |
| 1669779906 | Imacs, LLC | Internal Medicine | 1690 Dunlawton Ave Ste 120, Port Orange, FL 32127-8980 | 2011-02-23 |
| 1104056860 | Juan Pablo Blum Guzman | Internal Medicine | 3635 Clyde Morris Blvd, Suite 100, Port Orange, FL 32129-2300 | 2009-07-15 |
| 1336262146 | Ketul Raman Patel | Internal Medicine | 3635 S Clyde Morris Blvd, Ste 100, Port Orange, FL 32129-2300 | 2007-04-08 |
| 1396850152 | Sunil P Pasricha | Internal Medicine | 3635 S Clyde Morris Blvd, Suite 100, Port Orange, FL 32129-2300 | 2006-08-20 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.